Background. Over the past 15 years, the therapeutic breakthrough in the treatment of multiple myeloma observed primarily due to the emergence of new drugs. Since the characteristic of the disease is a chronic course with consecutive periods of remissions and relapses, the search for new effective treatment options with each subsequent relapse/progression is critical to increasing the survival of patients.Objective: to evaluate the role of pomalidomide in the treatment of relapsed/refractory multiple myeloma.Materials and methods. The results’ analysis of using pomalidomide-based treatment (Pd (pomalidomide/dexamethasone), PVd (pomalidomide/bortezomib/dexamethasone), KPd (carfilzomib/pomalidomide/dexamethasone), IxaPd (ixazomib/pomalidomide/dexamethasone), DaraPd (daratumumab/pomalidomide/dexamethasone), IsaPd (isatuximab/ pomalidomide/dexamethasone), EloPd (elotuzumab/pomalidomide/dexamethasone)) in pretreated patients, including own data, was done. Based on the RosNIIGT FMBA of Russia, 17 patients with relapsed/refractory multiple myeloma were treated; the frequency of achieving a response and the development of adverse events was estimated; the possibility of pomalidomide dose reducing with the development of adverse events was described without an apparent decrease of effectiveness.Results. The frequency of the overall response in using pomalidomide-based programs was 53 % (according to the world data, from 38 to 82 %). This drug is recommended for patients with multiple myeloma, even accompanied by the final stages of renal failure. The most frequent adverse event was grade III–IV neutropenia (30 % of patients). In 3 patients, the dosage of pomalidomide was adjusted with a decrease to 2 mg per day. In 2 patients, therapy was discontinued due to pulmonary embolism and bilateral pneumonia. After three courses of DaraPd, one patient achieved a complete response and underwent autologous hematopoietic stem cell transplantation.Conclusion. Pomalidomide-based programs in patients with relapsed/refractory multiple myeloma are an effective treatment option. Using dose-adjusted pomalidomide after the occurrence of neutropenia makes it possible to normalize the neutrophils level (more than 1 × 109/l) and continue anti-myeloma therapy, preserving the therapeutic effect and in individual patients with unfavorable prognosis factors to conduct high-dose therapy followed by autologous hematopoietic stem cell transplantation.

Aim. To establish correlation between CD34+ autologous hematopoietic stem cell (HSC) count and colony-forming units (CFU) in the same peripheral blood apheresis product samples before and after cryopreservation in multiple myeloma and lymphoma patients, and to assess clinical value of these parameters. Materials & Methods. Cell samples of peripheral blood cytapheresis product and cell cultures were studied before and after cryopreservation in 32 multiple myeloma and 25 lymphoma patients who underwent autologous HSC transplantation. The material was analyzed using culture technique and flow cytometry. Results. The paper provides information on the relationship between CD34+ HSC count obtained by flow cytometry, and CFU in cell culture obtained by cytapheresis of the same peripheral blood samples. A direct correlation was confirmed between CD34+ count and all the CFUs before and after cryopreservation in lymphoma patients. Correlation between CD34+ count and granulocyte-macrophage CFUs was revealed in multiple myeloma and lymphoma patients before cryopreservation. Conclusion. The parameter of colony-forming capacity used for the assessment of the functional HSC was shown to be equally reliable criterion for condition evaluation of autotransplant proliferative pool than CD34+ cells. Both methods should be applied for qualitative and quantitative evaluation of an autotransplant for multiple myeloma and lymphoma patients.

Secondary myeloid neoplasia may be a complication of intensive cytostatic therapy. The most common types of secondary neoplasias are acute myeloid leukemia and myelodysplastic syndrome. The development of secondary atypical chronic myeloid leukemia (aCML) is an extremely rare phenomenon. The paper describes transformation of secondary myelodysplastic syndrome to aCML 6 months after its diagnosis. The development of aCML was accompanied by additional chromosomal aberration as monosomy of chromosome 17. No mutations in the JAK2, MPL, and CalR genes were detected. It is concluded that the clinical course of secondary myeloid neoplasias is variable.

In this article we present the most up-to-date information about etiology, pathogenesis, diagnostic and treatment principles of primary central nervous system diffuse large B-cell lymphoma. We propose algorithm of diagnosis and treatment based on literature review and own experience. The main methods for diagnosis verification are magneto-resonance tomography and stereotactic biopsy of mass with subsequent histological examination including immune staining. The common first-line therapy regimen is high-dose methotrexate therapy. However long-term prognosis still remains poor. Adverse prognostic factors for therapy response are age > 60 years, multifocal lesions, neurologic symptoms,previous treated disease. Considerable part of patient have contraindications or high-risk of adverse events for high-dose chemotherapy treatment. Anti-CD20 monoclonal antibody has no neurological toxicity with intravenous and intrathecal administrations. Combination therapy with reduced dose methotrexate and monoclonal antibody can be a reasonable treatment alternative for old and disable persons. The further survival improvement would be achieved by patient stratification and using of risk-adapted treatment algorithm.

In this article we present the most up-to-date information about etiology, pathogenesis, diagnostic and treatment principles of primary central nervous system diffuse large B-cell lymphoma. We propose algorithm of diagnosis and treatment based on literature review and own experience. The main methods for diagnosis verification are magneto-resonance tomography and stereotactic biopsy of mass with subsequent histological examination including immune staining. The common first-line therapy regimen is high-dose methotrexate therapy. However long-term prognosis still remains poor. Adverse prognostic factors for therapy response are age > 60 years, multifocal lesions, neurologic symptoms, previous treated disease. Considerable part of patient have contraindications or high-risk of adverse events for high-dose chemotherapy treatment. Anti-CD20 monoclonal antibody has no neurological toxicity with intravenous and intrathecal administrations. Combination therapy with reduced dose methotrexate and monoclonal antibody can be a reasonable treatment alternative for old and disable persons. The further survival improvement would be achieved by patient stratification and using of risk-adapted treatment algorithm.

Summary. Interna tional non-interventional electronic observational study (eVOBS) is ongoing for prospective evaluation of the efficiency and clinical outcomes of bortezomib-based therapy for primary relapsing/refractory multiple myeloma (MM) in the ‘real-world’ clinical practice setting. A total of 691 patients were included in the study in Russia. The patients were observed for at least 3 years since the beginning of therapy. The patients received bortezomib as monotherapy or in combination with other drugs within the framework of the study. Overall response rate was 86.1%, complete response was attained in 33.9%, near complete response in 21%, partial response in 26.8%, and minimum response in 4.4%. The median survival has not been reached. These results indicate the efficiency and safety of bortezomib as monotherapy and in combination with other drugs in previously treated patients with relapsing/refractory MM.Key words: multiple myeloma, observation study, bortezomib Для корреспонденции

International non-interventional electronic observational study (eVOBS) is ongoing for prospective evaluation of the efficiency and clinical outcomes of bortezomib-based therapy for primary relapsing/refractory multiple myeloma (MM) in the 'real-world' clinical practice setting. A total of 691 patients were included in the study in Russia. The patients were observed for at least 3 years since the beginning of therapy. The patients received bortezomib as monotherapy or in combination with other drugs within the framework of the study. Overall response rate was 86.1%, complete response was attained in 33.9%, near complete response in 21%, partial response in 26.8%, and minimum response in 4.4%. The median survival has not been reached. These results indicate the efficiency and safety of bortezomib as monotherapy and in combination with other drugs in previously treated patients with relapsing/refractory MM.

В статье рассмотрены современные теоретико-методологические подходы к генезису структуры управления промышленным предприятием. Представлены основные принципы формирования системы управления экономической устойчивостью. Научно-информационный журнал «Экономические науки»